Jeb Bush is one of many presidential candidates who's been pressed for his positions on tackling substance misuse while on the campaign trail in New Hampshire.

Credit Casey McDermott, NHPR

New Hampshire’s heroin and opioid epidemic has become a front-and-center issue on the campaign trail – prompting presidential candidates from both parties to answer question after question about what they’d do to fight addiction on a national level.

On Tuesday, a handful of Republican candidates offered up their views on how best to tackle addiction at an event hosted by the Addiction Policy Forum, a Washington-based group focused on these issues.

Of the candidates who attended, two – Carly Fiorina and Jeb Bush – recalled their experiences as parents of people who struggled with addiction. Fiorina’s stepdaughter, Lori, died in 2009 after what the candidate described as a battle with “the demons of addiction.” Bush’s daughter, in his words, “had to go through a very public challenge” as she struggled with addiction during his time as governor – but is now in recovery.

Several of the candidates – Bush, John Kasich and Chris Christie – also pointed to the work they’ve done to address drug issues in their home states as a possible blueprint for what they might pursue as president.

Here’s some of the main points made at Tuesday’s forum.

John Kasich

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2:44

The Ohio governor touted several steps he tried to take in his home state: cracking down on so-called “pill mills,” enacting new protocols for doctors prescribing opioids and strengthening prescription drug monitoring, among other things.

Expanding Medicaid – a decision that’s come under scrutiny by some fellow Republicans who oppose the program, part of the Affordable Care Act – also allowed Ohio to do more to treat those with addiction, Kasich said.

“What’s happened is because we’ve expanded, we’ve freed up a lot of the resources at the community level."

Kasich argued that school-based programs focused on kids and teens, along with providing mentoring opportunities, are particularly important tools to prevent drug use. But when asked later about whether he’d restore funding cuts to several national school-based programs, Kasich was skeptical that spending more money had to be part of the solution.

“We don’t need to give a schoolteacher money or training to tell a kid don’t get on drugs,” Kasich said. “Now, if somebody can convince me we need money I’m willing to listen – but I haven’t figured it out yet.”

Chris Christie

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The New Jersey governor has held several campaign events focused on addiction. Outside of the campaign, the state's substance abuse task force asked the governor's policy advisors to discuss work done in Christie's administration on issues related to addiction. (Senate Majority Leader Jeb. Bradley, the task force chairman, has since endorsed Christie’s presidential bid.)

At Tuesday’s forum, Christie called for a shift in the way the criminal justice system approaches drug issues.

“There is no reason for us not to have drug courts in the federal district courts,” Christie said Tuesday. “We are jailing too many people whose offense is that they’re addicted to drugs – we put them into prison, we don’t give them treatment, and then they come out and have greater problems when they come out, and we wonder why.”

Christie said he signed a law in New Jersey to expand drug courts to every county and to stipulate that first-time nonviolent, non-dealing offenders go to one-year mandatory treatment instead of jail.

As he called for more compassion toward those struggling with addiction, Christie pledged a significantly stricter approach when it comes to marijuana enforcement: “There will be no mixed messages from the White House, I will not be misunderstood. Marijuana laws will be enforced in this country.”

Among other steps, Christie said funding should be moved away from corrections to support more treatment, and more rules are needed to make sure that insurance companies treat drug-related issues like other medical conditions.

Carly Fiorina

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The former Hewlett Packard CEO opened with a story about her stepdaughter’s struggles with substance misuse, using her personal experience to highlight issues that she’d like to see changed.

Among other challenges, Fiorina recalled how difficult it was to communicate with her stepdaughter’s medical providers with updates that might have allowed someone to intervene – and suggested that it might be worth reevaluating the privacy laws that inhibited this kind of communication.

“I remember desperately trying to chase through Lori’s doctors, and because of HIPAA laws, it’s virtually impossible,” Fiorina said. “If you have an addict who is an adult, it’s virtually impossible to intervene if they don’t want you to know what they’re doing.”

“We really have to re-look at so much,” Fiorina added. “How we fund treatment, how we treat addicts who have broken the law as a result of their addiction, but we also have to look at some of these laws that were intended to protect people, but that serve instead to isolate them from people they love and allow them to game a system in a way that’s deeply harmful.”

Fiorina, like other candidates, called for reforms in the way the criminal justice system approaches drug penalties and more funding for treatment services – and for mental health supports, noting that such issues are often co-occuring in those struggling with substance misuse.

While she didn’t have her own policy track record to point to, Fiorina highlighted programs already underway in several states – praising Texas’s use of drug courts, a program in Georgia that provides education and training to inmates, and the “Communities for Alcohol and Drug Free Youth” program in New Hampshire.

Jeb Bush

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1:48

Bush, as with Christie and Kasich, also pointed to the work he did as governor to address drug problems in his home state. And, as with Fiorina, he also said his views on how to approach drug issues were informed by his experience watching his daughter struggle with addiction.

“My daughter graduated from Tallahassee Community College, and that was a big deal for us, and that graduation I went as a proud parent,” Bush said. “But the one I’ll never forget was the drug court graduation she had in Orlando, Florida.”

“It was an extraordinary event,” Bush added.

Among other things, the former Florida governor called for strengthened prescription drug monitoring efforts and an expansion of drug court systems in all states during his remarks Tuesday. He also pointed to his efforts, as governor, to expand drug treatment – arguing that, in this case, the decision to spend more government money was the right one.

“Just in case you might have forgotten, I’m a conservative,” Bush said. “I believe in limited government. I don’t think that every problem needs to be solved by more spending – but this was a huge priority. And conservatives and liberals alike believed it to be that way.”

Bush, who just this week outlined a more specific set of policy priorities for fighting substance abuse, also called for more focus on measuring what approaches are actually working and using those outcomes to determine where to put funding. He also stressed a need to do more to “stop the flow” of drugs that come in across the country’s borders.